Infant Maltreatment in Canada: Predictors of Substantiation

Background/purpose:

Maltreatment that begins in infancy may become chronic and developmentally deleterious if infant and family needs are unaddressed (Putnam-Hornstein et al., 2015).  Infants’ physical vulnerability and total dependence upon caregivers makes them more likely than any other age group to suffer injury and death (Klevens & Leeb, 2010). Yet, despite the serious implications associated with maltreatment in early childhood, few studies have explored the factors associated with the decision to substantiate child welfare investigations involving infants. The purpose of this study is to identify predictors of maltreatment substantiation in child welfare investigations involving infants in order to: (a) better understand factors that contribute to abuse and neglect of infants and (b) inform the design of effective interventions that will meet the needs of this uniquely vulnerable population and their caregivers.

 

Methods:

Data were drawn from the nationally representative 2008 Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2008). The CIS-2008 employed a multi-stage sampling design to select a representative sample of 112 child welfare agencies across Canada and then to select a sample of cases within these agencies. This analysis focused on investigations involving infants under age one who were investigated for abuse or neglect (n=1,452). Weights were applied to generate national annual estimates. Predictors of substantiation were identified using chi-square and logistic regression analyses.

 

Results:

Substantiation was predicted by the type and characteristics of maltreatment as well as risk factors at the household and caregiver level. Investigations involving caregivers with no source of income were over three times more likely to be substantiated compared to investigations involving caregivers with full time income (OR=3.173, p<0.001). Caregivers with substance abuse issues and few social supports (OR=2.07, p<0.001 and OR=1.96, p<0.001, respectively) were also more likely to be involved in a substantiated investigation. Compared to physical abuse investigations, cases involving neglect, emotional abuse and intimate partner violence were more likely to be substantiated (OR=2.55, p<0.001, OR=2.99, p<0.001 and OR=5.97, p<0.001, respectively). The strongest predictor of substantiation was mental or emotional harm for the child. Infants who displayed signs of mental or emotional harm were almost seven times more likely to be involved in a substantiated investigation than infants who did not show symptoms of such harm (OR=6.85, p<0.001).

Conclusions:

The findings suggest that a constellation of risk factors are predictive of substantiated maltreatment in infants. Clinical interventions and policy-level changes are needed to prevent recurrent maltreatment and address socioeconomic disadvantage, lack of social support and caregiver drug and alcohol abuse. It is also critical to address mental and emotional harm in infants who have been maltreated. Infants are dependent on caregivers for their emotional well-being in addition to their physical safety. There is a clear need for child welfare mandates to extend beyond physical safety and address the caregiver-infant relationship in order to promote secure attachment, infant mental health, and healthy early child development.